Empowering Longevity: Health and Wealth in Harmony

with Lauren Dunning and Caitlin MacLean,

Director, Center for the Future of Aging, Milken Institute | Senior Director, Innovative Finance, Milken Institute

This week on the Art of Aging, host Michael Hughes chats with Lauren Dunning and Caitlin MacLean of the Milken Institute. Lauren serves as the Director of the Center for the Future of Aging while Caitlin is the Senior Director of Innovative Finance at Milken. During the episode, the group discusses the convergence of aging and financial innovation. They explore the challenges of demographic change, focusing on healthspan, financial security, and housing for older adults. The conversation also emphasizes the importance of integrated care, the impact of chronic conditions on healthcare costs, and the need for innovative solutions to support aging in place. They conclude by discussing the Aging Innovation Collaborative, a partnership aimed at improving the well-being of older adults through better healthcare, housing, and community engagement, and more.
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Highlights from this week’s conversation include:

  • Introduction of Lauren and Caitlin (1:11)
  • The background of the Milken Institute (1:53)
  • Milken’s activities and focus on research (3:16)
  • The Work of the Center for the Future of Aging (4:17)
  • Collaboration and partnerships in addressing change (8:14)
  • Four Focuses of the Center for the Future of Aging (10:13)
  • Exploration of systemic and personal challenges in long-term care (16:20)
  • Societal shifts, financial burdens, and housing challenges for older adults (19:45)
  • Technology’s Role in Healthcare and Home Care (22:52)
  • Affordable Housing and Care Solutions (25:48)
  • Middle-Income Housing and Financing Challenges (27:48)
  • Virtuous Circle of Housing and Health (29:05)
  • Innovation and Technology in Care Solutions (33:08)
  • Partnership for Aging Innovation Collaborative (38:05)
  • Future Vision and Impact of Recommendations (39:32)
  • Personal Growth and Reflection on Aging (43:03)
  • Abundant Aging and Intergenerational Relationships (47:18)


Abundant Aging is a podcast series presented by United Church Homes. These shows offer ideas, information, and inspiration on how to improve our lives as we grow older. To learn more and to subscribe to the show, visit abundantagingpodcast.com


Michael Hughes 00:07
Hello, and welcome to The Art of aging, which is part of the abundant aging podcast series from United Church homes. On this show, we look at what it means to age in America and in other places around the world, with positive and empowering conversation to challenge, encourage and inspire everyone everywhere to age of abundance. And today, we’re particularly excited that we have not just one, but two amazing guests for the show. Lauren Dunning and Caitlin McLean are here to represent the good work development of Lauren serving as a director with the open center for the future agent, you, Caitlin as a senior director of Milton’s financial innovation labs. And this is pretty important guys, we’re seeing the kind of the convergence of aging and Financial Innovation in one here. And this is something we’ve highlighted on the podcast before the worlds of finance in Asia are converging. Because more and more stresses are being placed on the nation’s health system, and on families, as they face the cost of long term care, many of which, as we know, in fact, there really is no long term care benefit in Medicare. So Lauren, Caitlin, welcome.

Lauren Dunning 01:14
Thank you. We’re excited to be here. Awesome.

Michael Hughes 01:16
And just a reminder that this podcast series is sponsored by the United Church homes, Ruth frost Parker center for abundant aging. To learn more about the center, including our annual symposium in October, visit www DOT United Church homes, slash poker hyphen center. Alright, so let’s get into it. Big subject. As always, we love big subjects for this show. But I’m really so glad that you guys have given me some of your time and maybe give a little bit of insight to this and to see how Milken is addressing it. So can you tell our listeners first about the Milken Institute and your respective centers?

Caitlin MacLean 01:53
Happy to and again, yeah, thank you for having us. So the Milken Institute, we’re a nonprofit, nonpartisan Think Tank. And we focus very broadly on how people can advance having a meaningful life. And so we look at a wide variety of topics, but really predominantly through a financial lens. And we do that through three pillars. So we have finance as a pillar of health, and then philanthropy. So largely stemming from our chairman, Mike Milken, his time in the capital markets, as well as his interest as a philanthropist. So we’re probably most well known for two core activities, our convening power. So our annual flagship event is our global conference. It’s about 4000 people in Los Angeles each year, looking at a wide variety of social issues. And then alongside that, also regional summits where we have different offices around the world, including places like Singapore, Abu Dhabi, London. So that’s kind of the convening side of the house. And then we also do research as a think tank. And we have a variety of different centers under each of our pillars that do white papers, indices, my team, we do what we call financial innovation labs, which we can talk about, but really kind of the idea is to have both research and convening that can lead to meaningful results. And I’ll let Lauren talk about one of those centers, which is our Center for the Future of aging. Absolutely.

Lauren Dunning 03:17
As you mentioned earlier, I am with the future of aging, I sit within my health, and we work to advance healthy longevity and financial security for all through research, convenings, multisector, partnerships in the elevation of high impact policies and practices. And so we collaborate really, with leaders across all of the domains that have a hand in aging, which as we know, it spans as we keep saying, finance and aging. And so we work with business floods, we nonprofit governments, etc. To build a better future for all ages. And we do this through four practice areas where we work to promote healthspan advanced integrated care solutions, improve dementia care, and accelerate financial longevity preparedness. And this past year, I was especially excited to collaborate with Caitlin and her team on some really exciting work on middle income, senior housing. And so we’re excited to dive into that with you a little bit later.

Michael Hughes 04:17
Yeah, and that’s it. And, you know, I think we, you know, just for our listeners, this is really, you know, I think the Milken, the center of the future on aging group, Lauren’s a part of this has really been part of our, on our radar for the last few years, they’ve been doing amazing work in the space, they convene an awesome group of people. It was just in the last year where they really just got a sense of that full picture of what Milken does and how these different disparate parts come together. And it seems like you really are kind of putting the right side type of investigations in place for a very important issue. And I’ve said before on the show, and probably guys that I’m not aware of any trend happening outside of climate change that really is predictive of future wants, future stressors, really future anything then this idea of aging. The fact that we have this kind of people call them all sort of silver tsunami, which we hate, because it’s kind of an ageist term tsunamis are disruptive, or Python and things like that. So it is that the type of thing that Milken kind of looks at and says yet, we want to look at that this is so obvious, this is so big. This is right for Milken.

Lauren Dunning 05:33
Yeah, I mean, we’ve Believe it or not been at it for a while. About 13 years ago, our founder, Paul Irving, started our work at the Center for the Future of aging. So we’ve been looking at this and really seeing rapid population aging, and we can give you all the statistics about why it’s important, right? We’ve seen 1,000% growth rate between 2010 and 2020, for the 65 plus population, or slated to cross that line where we’ll have more older people than younger people. And we saw this coming. But we’re really like, we’re sitting there today, right? It was the horizon. And now we’re here and we need all of these system changes. And that fact that we’re in this global megatrends that everyone’s starting to recognize, right, yeah, as you said, in the same breath, as climate change, globalization, you know, the impact of AI, all these things, it’s, it’s here now. And I think that’s just accelerating our work on the future of aging and giving it, you know, greater urgency and helping us spur innovative collaborations, like the work we did with Caitlin’s group. And then I also know that we’re working across lots and lots of big important issues, just like aging, and sort of the need for housing and care that presents but other issues too.

Michael Hughes 06:55
And it seems like with just milk, just talking about sort of Milton, and it’s in the spirit of what you guys do, you know, I’ve observed, you know, I, you know, I’ve been working in, you know, aging, health aged check pretty much my entire career. And, you know, I just, gosh, since 2015, it seems like we’ve been kind of pounding on the table saying pay attention to this pay attention is pay attention to this. Milk is also an organization that pays attention to this, pays attention to this, and pays attention to this thing. And now, you know, the magic number out there is kind of like in 2034, we’re going to have more people over the age of 65, than we will under the age of 18. And that’s 10 years away. And it’s interesting, because as I see your convenience happening, and I see that convenings happening with people like AARP and Stanford and so on, every year, you know, the group seems to get bigger every year, you know, representatives from new companies, you know, they gotta show up, but you know, kind of for the first time, right, suddenly, you’re getting x y Zed company to come in, or here’s a good manufacturer here. So just medicine, you know, all of these are us kind of seeing the same thing. Do you think that Milken is ready to welcome those people as they come into these investigations? Is that kind of your MO? Yes, not? Yes. Yeah.

Caitlin MacLean 08:14
I mean, ya know, I would say, you know, generally across the Institute, and more than can certainly talk about the Center for the Future of aging, but you know, kind of very similar built into our DNA is trying to bring in, you know, kind of a diverse set of stakeholders to look at a specific issue, because at the end of the day, we can’t solve things on our own. And so fundamentally, we have to collaborate, we have to partner and you need champions, not just in a specific industry or sector, but you need them across the board. Right. So I think that the the interesting thing about the Institute and a platform that we have is that we do have such a strong finance network, investor network, the policy angle, the corporate angle, as you said, Mike, not just kind of the traditional kind of corporates in the aging space, but also thinking about, you know, kind of every industry because, as we’ve talked about, you know, this silver tsunami is affecting everyone in every sector. And so I think that’s the value add, for us is to be able to look at this holistically and say, everyone’s doing amazing things, but perhaps in their own silos. And so can we bring everyone together? And say, if there’s a couple of solutions to get to a scale, can we all collaborate in a way and kind of move as one? And so, you know, kind of building out some of those other kind of champions, maybe the unusual suspects outside of just preaching to the choir, but certainly, so that we do that, across the Institute and, you know, looking at every kind of topic that we focus on, but certainly Lauren and the team at the Center for the Future of aging, that’s, that was sort of a fundamental kind of premise to set up the center in the first place.

Michael Hughes 09:47
Yeah, and I want to go into the into some of the investigation areas that you’re talking about LoRa and in the center, particularly Can you can you just say again, what those four focus areas are and I know that choose Those four focus areas must have come from, you know, deciding what 300 focus areas that you could probably, you know, you know, work with, right. So Ken, what are those four areas? And why were they chosen?

Lauren Dunning 10:13
Yeah, absolutely. So we’re looking at promoting healthspan, advancing integrated care solutions, improving dementia care, and accelerating financial longevity preparedness. And really these four practice areas, they’ve developed over time through the work that we’ve done, looking at the intersection of healthy longevity and financial security. And we know that there’s a big feedback loop between those two things and a real need to connect them together. And so each of those four areas connects those two pieces in a meaningful way. And in a really robust way that informs the way we also create projects or partnerships, or, you know, different types of solutions under each of those areas. And so those four areas are informed by the many years of work we’ve done, and then also processes with our stakeholders to continue refining our role and where our unique blend of being a nonpartisan convener is needed to bring unique thinking to the table so we can harness that collective brainpower, we have an incredible group supporting us, which is our future of aging Advisory Board, which is comprised of incredible leaders in the field, that are really looking to drive innovation as we work to respond to some of the challenges, but also bring about some of the benefits of demographic change and population aging.

Michael Hughes 11:42
Yeah, and I was gonna go to learn. I’m glad you mentioned that. Because, you know, when I’m so in, this is where I love having both you on the show just the intersection of longevity, and financial security. And I look at my son, and I think, look, he’s not only going to have a far better chance of living past 100 years old, and all of us, but many of those years are going to be healthy. So you have these things like healthspan, you have things like the integrated care solutions, which I read is more like holistic, you know, actual healthcare, not sick care that we have today. Right? I have dementia care, which is absolutely a crisis for families. And as such, you know, it is such an important issue. And then financial preparedness. So we think about what is the balance that I guess it’s thinking and thought leadership, for on Nillkin on addressing the current kind of ability for people to pay for their costs of care. And how much of that is looking at things like how we rethink our careers, how we rethink productivity, how we rethink purpose, as we get into our 80s and 90s. I mean, there are a lot of tropes around being in your 80s and 90s. Today, and I can tell you, a lot of them are just not true around people’s ability to be creative and productive, and all the rest of it. So you guys are thinking about both. But is one more important than the other right now?

Lauren Dunning 13:13
I do. I think you have to have both rights. Meson, there’s what we’re thinking about is a right, a life course approach, right? We always say we’re not the Center for the Future of aging, right? We’re focused on the future of aging, which involves all generations. And so yes, we need solutions. Now for what we know to be an aging population that will have more older adults over 65 than we’ve ever had before, and how we need to adjust our systems of care in our housing and how we think about, you know, life course and purpose and work. But we also know that we’re looking to younger generations, not only for solutions, and to be a part of how we work through that, because everyone is interconnected. Right? We have families, right. And when we talk about, you know, financial preparedness for longer lifespans, and shifting demographics, that’s, you know, macro issues around, you know, governments. And that’s also right, how we create conditions for people to be able to afford the care their families might need, we’re seeing the rise in intergenerational housing. For many family members, we know that, as we have seen the number of potential family caregivers, for older adults declining, there’s gonna be a greater role for a smaller number of people for each older adult, and you have to figure out some solutions at work. And so there’s the solutions for the short term, but then also looking at how we think about what it means to have a 100 year life and what do your careers look like? And what does work look like? And what does care look like? And how do we extend our health span, so that we’re looking to make our years of healthy lives? Live Metro lifespan, and those are all things that happen earlier, right? Thinking about how we prepare for our longer lives financially, within as an individual family, and then as well as for our health, because those are all things that, yes, you can work on now. But many things, it’s about behaviors that we start earlier in our lives and how that, you know, pays dividends many years later. And so it’s the macro is the micro, it’s the today and also tomorrow.

Michael Hughes 15:21
And I want to get into one particular project that we’ve worked on just this past year that I think we’re really excited about. It’s just one I think of many projects that you guys do that the Korean pack in space. But I just want to pick up on what you just said LoRa and I want to put Caitlin, as our representative from the financial innovation labs on the spot here with a question, why can’t people eat their vegetables? Why can’t people, you know, what is it we did? We, again, with his sort of realization that Medicare does not pay for long term care needs, that two thirds of us are going to need to pay out of pocket for long term care at some point in our lives, that the cost of that is going to probably be over $100,000, in your 80s, in your 90s, in your hundreds, you know, and we’re sitting here in our 20s, all of us. And we’re saying, So what’s keeping people from eating their vegetables?

Caitlin MacLean 16:19
So many issues? Right? What for vegetables and for long term care? You know, I think that there’s a few different kinds of system wide changes that have to happen. I think that when we started doing a project a couple of years ago, looking at financing long term care, and you know, the challenge was that everyone kept saying to us, you need to blow up the entire system, because the system isn’t working. And we have to completely change it. Because the way that we age, as you said, like the way that we age, you know, how long we’re living, the health conditions that we have, but also how we work, how we get paid, how we have health insurance is all changing, and it’s very dynamic. And so if we don’t have a system that can respond to those dynamic changes, then what we’re doing is getting stuck. And I think that’s, you know, kind of where we’ve seen a lot of the long term care insurance market in particular, you know, seeing a lot of the insurers leave the market over the past 20 years, you know, having some of the challenges in terms of, you know, kind of not really predicting what some of those trends might be and what that might mean, for the overall system. And so I think there’s those big kinds of systemic issues that are sometimes very daunting to change and to try to fix. And then there’s just the personal like, why is Kaitlyn not eating her vegetables? And because, you know, I don’t know, they don’t taste good. No, they’re not delicious. But I think it’s also, you know, why are you not saving? Are you not saving, because your employer doesn’t have, you know, kind of opportunities for you in terms of the right options for, you know, insurance, you know, kind of long term care insurance or the appropriate savings plan? You know, are there challenges in terms of the cost of housing and how much that has increased over the years, and therefore, people not saving the cost of college? You know, you see, generationally, a lot of younger people, as we’re all in our 20s younger people who, you know, can’t necessarily recover from student loans, and then a mortgage in the same way that they, you know, were able to, you know, 20 3040 years ago. And so I think that we’re seeing both those kinds of systemic issues of how we shift entirely how the public sector as well as the private sector offers insurance in a different way, but also just individually, how do we change our practices? And do we have the right tools to do that? So the work that we had done on long term care was looking both at, you know, what are some of those options for Medicare and kind of, you know, kind of government funded kind of options? What are things like hybrid plans on the private side to offer that an employer could offer that are not just life insurance or long term care, but could be a combination of the two? And then as well, as you know, what are the individual kinds of savings and kind of options that we all could utilize? So I think, from there, then obviously, that goes to, as I said, the incredible cost of housing and looking at, you know, kind of how do we make things not only how do we plan better and save better, but then how do we make things cheaper, so that if Kaitlyn doesn’t eat her vegetables, and you know, I haven’t saved as much as I should have, my housing is not going to bankrupt me either way. And it’s going to be, you know, kind of not be so, so much of a financial burden.

Michael Hughes 19:45
Yeah. And I hope that it will become a societal shift where we’re not necessarily, you know, blaming people for not having those resources when they’re older. I mean, I have to think about just and I do want to get to the housing subject, because this is a great example of it where you know, we’ve had, you know, people who are in assistive housing situations to the elderly generally would have had pensions, that does not exist today. We’ve had, you know, events like the recession of Oh, 80909, or what have you, the white got a lot of equity. We’ve got student loan debt that keeps people from being savers, you know, and then we have a workforce, which tends to kind of limit people as they work in their 60s and 70s. Those are productive years that could be used for saving. And you know, and that future preparation. So you’re definitely blazing a trail early on these things. But these are very important questions. And you’re right, the cost of housing is, you know, increasing the cost of owning a house is increasing. So what we’re saying is, you know, United Church homes are very compelled by this idea of middle market, because you know, we’re an operator of affordable housing properties for older adults. And we operate middle market housing. And we recognize that there is a whole huge cohort of people that will want to and need to move into a more supportive environment, but they will not be able to qualify for the Medicaid program, which is where we see that benefit today. So designing and standing up new types of middle market properties. And believe me, we can’t make them fast enough, you know, and we are looking around supporting people as they age and home with technologies and services. And if we have some very clever solutions there, much of which has been captured in the report that we helped you guys make last year. But in time, why did you guys decide that last year was going to be all about house and we it doesn’t seem like a natural fit with the four areas you talked about before Lauren? Yet? As we look into it, of course, it’s a fit. So can you take us through that decision process?

Lauren Dunning 21:44
Absolutely. I think that one of the things that comes through in the report, but that also is a part of that integrated care area that we talked about, right? Because we’re seeing this convergence, right of health care, of supportive services, and of community or housing, right, and how all those three things come together to enable people to live well in the place they call home. And oftentimes, senior housing is sitting in the middle of all three of those things. And so that’s really how it can come together and how we can figure out how to make better outcomes for people with their health and with their financial well being. And in terms of just the How did we get to this specific project? Right. Caitlin earlier mentioned that we did some previous work on long term care, financing and delivery. And then that project led us to a different one. The evolution in that was a report that came out in 2022, about advancing tech enabled health and home care, right, because we’re seeing this growing together of the health care in the home care, and how is technology driving that, and potentially a cost modifier. And in that work, we really dug and uncovered and found that systems change around this idea that these three things are growing together. And that we’re seeing many more health plans, thinking about social determinants of health, and really blossoming and the number of people who are interested in how these things fit together. That project led us to say we need to pick back up some of that previous work with our fantastic partners National Investment Center for seniors housing and care and CVS Health, who we had, right in our network to say, we think this is something that we can do together. And that is timely, because part of it is about timely, right? Are there right ideas, are there, right? A real feeling in the room that we could make a difference? And I think, right when you do things like go to CES and see the age tech collaborative, and right, the Samsung health house, looking at how we put all these things together to make people’s environments that support health and well being an aging community. Right, you can see that there’s a huge right interest, there’s action, there’s a scrum around it about how we can solve these issues, because partly people feel like they’re finding solutions, and we wanted to get everyone together to elevate some of them that we’re focused on. Right, both the financial side of housing and also how we integrate care in new ways that addresses both costs and, and improving outcomes. Yeah,

Michael Hughes 24:24
I mean, I think it all draws together, doesn’t it? I mean, you talk about, you know, where are we going to get hurt the most? Let’s talk about you know, you know, government programs and things like that as the age wave continues to progress. We’re gonna get hurt on Social Security, but we’re really gonna get hurt in health care. And, you know, I think what we found in our industry is that the people that cost the healthcare system the most are certainly people with multiple chronics but also people with social needs and functional limitations. And I’m going to quote the Commonwealth Fund here where they’re saying that you know, if you’re got three or more chronic issues, you’re probably going to cost the healthcare system about 50% more on average. And you add a functional limitation to that mix, like walking or dressing or what have you, it’s 330%. More on average. It’s about 5% of the patients that drive 25% of all healthcare spending. And it’s all stuff to do with quite frankly unsupportive environments, trips, falls, you know, the people who act out of desperation to try and get it, get basic needs met, things like that. And we know, with our own programs, that we move the needle on outcomes simply by just making sure people have the right community program in place. And you know, with our recent affiliation with CareSource, in the MacBook Air, Harpreet tower, the CEO of CareSource, saying that, you know, when people are housed, other things tend to fall into place, right? You’re not couchsurfing, you’re not going from family to family, you’re not. So I can just see the potential of all that’s been unlocked. And I just thought that the that a lot of the stuff that is so National Investment Center, or Nick, I just thought that, you know, just there were just some wonderful, interesting and actually talk about him now, just ideas that sort of come out, like who fight and who finances middle income housing, where can we find opportunities to develop middle income housing, and are so glad to see that, you know, you guys were really focusing on middle income housing as a subject this past year, and we had such a terrific time working with you and so many others, to to really dive into this, we know that, at least, you know, you know, church homes, middle income housing is important to us things we see every day as an affordable housing operator as well, people who simply cannot afford to move into middle income, that cannot also qualify for Medicare, only that increase over time. So that leads to of course, a lot of conversation about what new housing options are available, because people need to move oftentimes, because they just simply can’t live at home anymore, or the tech solutions to enable somebody to age at home until the point or at least delay that move into senior housing and save all that costs. And it makes perfect sense to me that health plans are really interested in this because, you know, I’m gonna Well, we have an affiliation with say that once people are housed, you know, everything else seems to fall into place. You know, it’s not couch surfing, you’re not staying with family, you’re not. So it’s just that more and better opportunities for housing are important. We did a lot of work last year, and I think we put out a terrific report. So first of all, for either of you, can you tell us where we can find that report? And second of all, just maybe just a few of the recommendations that were discovered, you know, and put out there as a result of all that great collaboration that we

Caitlin MacLean 27:47
had. Certainly, so definitely go to our website, Milken institute.org. You can find the world tour there. And certainly on our LinkedIn and our Twitter and any social media that you follow, you’ll find the report, I think, you know, what we were most excited about is, as we were talking at the beginning about this intersection of health and finance and aging and finance, is that there’s a sort of virtuous circle of you know, kind of housing as healthcare and people needing to have access to safe, affordable housing. At the same time, the people who are providing the housing, also benefit from you being healthy. And so I think it is that virtuous cycle that we were trying to really dive into, and then try to leverage to say, let’s get more investment into affordable hair, and housing, because that benefits us as humans, but it also benefits the people who are providing it and investing in it. And so, you know, coming from it, as we’ve been talking about the challenge of this middle market, and you know, for those who don’t qualify for Medicaid, and for those who don’t have an income bracket that would qualify for what we call low income housing tax credit from the HUD side of the government, you know, this band of maybe 80 to 120%, what they call area median income, you know, how do you have those people have access to affordable options, when they certainly, you know, for the most part, most of us can’t afford luxury and don’t want to spend down? And so I think, you know, what we found was that you can look at this in two ways. How do you manage the cost of the housing, the real estate itself? And then how do you manage the cost of care? And to be honest, I would say, as a finance person, we were very excited to focus on some of the housing costs. And then you know, the folks like you were saying to us, listen, focusing on just the housing is helpful, but marginally impactful at best because a lot of the cost is actually on the care side. So we’re trying to do both. We’re trying to look at housing and real estate as well as the care of fully acknowledging that the majority of the costs are on the care side in terms of what makes it so much more challenging for providers. And so I think, you know, coming from coming out of COVID, coming out of, hopefully out of, at some point, this interest rate environment that we’re in, you know, there are a lot of challenges in terms of supply chain issues and financing issues, where it’s now a ripe time for people to look at properties that may not have been successful coming out of the pandemic, or haven’t been successful for decades. And maybe there’s a time now to really build this middle income focus. So a couple of our solutions really did end up looking at the cost of real estate, that cost of housing. And so one of the things we’re most excited about is this idea of a social enterprise that would be similar to a land trust, where those properties that perhaps were higher in a kind of luxury market, some might have been middle income, perhaps didn’t make it through COVID, or, you know, coming out of the pandemic, maybe had some challenges in terms of being rundown, haven’t had the, the operations and maintenance that they should have. And so they really need some support, because they can’t compete, they don’t have the latest technology, they don’t have the latest services. And so can we take those properties and with a group of experts really help to make them, you know, kind of have a better kind of appeal for the middle market, as well as help rehab them financially and provide some capital to really get them to a place of stability, both in terms of operations and finance. So we’re very excited about some of the outcomes there around this land trust model. But there’s also, I think, we’ve been talking about, you know, who funds this, who invests in this? Well, first of all, more people should not be enough people, I guess, is the answer. We need more people to invest in this middle income, you know, segment of the population. And so we’re trying to provide options through the recommendations for people to allocate capital. So if you’re saying, Hey, I’m an investor, I care about real estate, but I also care about health, because I understand that there’s an economic component to that, how do I allocate funds. So we have other recommendations of you know, different types of revolving loan funds and impact first funds, where if investors have an interest in providing capital that can make them the return they’re looking for, but also have this social impact? There is a vehicle there for them to easily allocate capital. So those recommendations, you know, we really focused on, you know, can we help existing buildings that are operators that are challenged financially, or operationally, can we try to engage new investors by creating these kinds of opportunities in these models to allocate capital? Then there’s the big piece of it, which is the care side? And since that’s the harder part, I’m going to give that to Lauren, to answer the bigger challenge, but we do have recommendations as well to think about how do you manage the cost of care? So Lauren, take, take the hard vegetable question.

Lauren Dunning 33:08
We do. We do have recommendations here that we’re really excited about. And partly, it’s because we saw a lot of innovation amongst all the people that we were talking about, or talking with, we all are now talking about them. But so we saw this innovation, people making decentralized models that allow people to access more or less care as their needs fluctuate over time, right. And that’s really important when we’re thinking about the care equation is how to get people the right amount of care at the right time, but also be able to meet them where they get to, and maybe back again. And then we see people that are trying to address challenging workforce issues around for example, not having the capacity to afford rising labor costs, while still maintaining affordability for middle income, older adults. And so looking at volunteerism as a way to address that. We’re seeing people extend out of right, the four walls and you can talk extensively of this of a building and out into a community and leveraging existing community services, as well as partnerships in health care. And that healthcare partnerships piece turned out to be a really big piece because it’s intertwined with another piece, which is how do we figure out how we insert technology into the equation, right to potentially modify costs on both sides, right around making sure people have safety and security and we’re actively monitoring chronic conditions and monitoring people’s health status effectively so we can interview intervene once again, at the right time, before we see any escalation that affects people’s well being. And then there’s all this other you know, we’ve talked a lot about chronic conditions, and people’s health status. We also need places that give people the potential for community, right and that’s why we’re calling it aging and community because purpose and engagement are powerful. all modifiers in our health span, right, we know that, for example, people with positive perceptions of aging Becca Levy’s research, that can have an enormous impact just on lifespan, right, plus seven years. And so we know, that’s another important part of the equation when we’re talking about health, and senior housing. And that’s potential upside as we talk about senior housing. And just to kind of end on one of our recommendations on on on this is that we took a look at this entire environment, and said, one thing that would help scale these partnerships, right partnerships with health care and senior housing providers in the industry, great technology, we really need to understand more about the cost and the savings on both sides and a value based care environment in order to value them in the long term and scale those types of partnerships, leveraging, right the rise of Medicare Advantage and other risk sharing models under Medicare. And so we decided along with our partners to look at how we launch a regional pilot. And how do we structure a regional pilot to generate data supporting partnerships between senior housing operators and payers in value based care environments? To really try to bridge right health and housing together?

Michael Hughes 36:18
Yeah, we probably got a natural experiment with you guys, you know, given the work that we’re doing with Radian Alliance, or Keras, and all that, so we’re gonna live it. And just to bring both out to both of these points together. And Caitlin, when you are talking, suddenly, I have this crazy idea in my head about like, you know, 20 floors of the Sears Tower in Chicago being taken up with senior housing because of the commercial real estate crisis. And can we kind of reappropriate and build the bathrooms and all that to kind of get that into space? Because again, it goes back to this idea of reliable demand for something in the future, you know, we know that people will, if the demand is, you know, 1x. Now, it’ll be 12x and 2040. Now, we’ve had some good financial cases. And then LoRa, I think what was really kind of wonderful that artists gallery is that a lot of these care solutions are actually not as complex as people think, you know, I know there’s the Institute of Aging in San Francisco, they believe makes 100,000 phone calls a year just to check in on people with no agenda at all. No, how are you feeling? Are you in any pain? Did you sleep? Well, just checking in, and guess what emergency room visits go down. And because that’s the biggest slice of Medicare spending, you know, just moving into a liberal saves a lot. So I have a very hopeful, you know, a perception of where we can go with this. I do feel like there are solutions out there, I feel that there’s logical solutions out there against a big opportunity for capital return. So it also you’re not just you’re not just bringing this to life to pilot projects, you’re actually doing, you’re launching something new with the National Investment Center. So that was a big outcome of last year of this project. Can you talk a little bit about what’s happening with NEC? Yeah,

Lauren Dunning 38:05
absolutely. So we’re so excited that 2024 will see us launch a partnership with NEC. And it’ll be termed the aging innovation collaborative. And really, it aims to improve the well being of older adults, through better health care, housing and community engagement. Really, we’re trying to pioneer groundbreaking ideas, and do research tailored for immediate application and actionability. We’re committing to accelerating innovation and aging. And the AIC will work to foster cross industry as we keep saying that multi sector approach innovation collaborations and offer tailored advisory services and other new services that really will have a dual purpose goal. And that’s to nurture faster innovation, and develop a self-sustaining economic model that will help us do more research faster, to scale, launch, and get more innovation out there. And so we’re really excited for the power that this has to help us not helplessly go faster, farther together. Right. And so we’re looking forward to launching that later this year. And hope to maybe be back here with you.

Michael Hughes 39:19
Well, I was gonna ask you, like, give me your fantasy headline for five years, or 10 years. Give me your version of we’ve discovered roasted cauliflower with paprika on top and now we’re eating our cauliflower.

Lauren Dunning 39:32
i You might have been at home in my recipes, wrote a freak on cauliflower is really where it’s at. It’s really good. But really, I think that our report which is innovative financing and care models to scale, affordable housing solutions for middle income older adults to get that long.

Michael Hughes 39:52
Say that again to that against one more time. I’m going to show you Yes, yes. This is the pilot gumbo. I’m going to read it out for listeners. So put it up to the camera. So video people can see it. So for audio people download this report. Okay, January 2024. We are recording this at the end of February 2024. This is the Milken Institute’s financial innovations lab, innovative financing and care models to scale affordable housing solutions for middle income older adults. I did that in my radio voice. I hope you could hear it. My mom tells me I speak too fast. She’s the only listener for this show. Mom, I hope that you got that.

Lauren Dunning 40:30
Thank you for that spot. Because that really gets us to the right place for what headlines we want in five years. And I think that these are consensus Bill recommendations, and they have a lot of legs. Right. And we’re already seeing, you know, the fruits of the efforts paying off. Right, we’re seeing people in the industry take up some of these. We’re excited for that action. I know, Caitlin, you’ve been working closely with some folks on one of them, and they’re off to the races, right?

Caitlin MacLean 40:58
Yeah, I would say I think what we found is we really are so appreciative of the fact that this platform allows us to kind of crowdsource these recommendations. And then the crowd really is excited to move them forward. And so we’re seeing some lenders and some kind of existing entities in this space, who are willing, especially on the kind of land trust social enterprise model, to really pick that up and run with it. Because as I said, you know, coming out of the pandemic, there really are properties that are underwater at this point. And so, you know, there’s an immediate, kind of short term need for the solution. But there’s also that can lead to a medium and long term solution to build out this kind of option for middle income adults. And so I think we’re excited about that we’re excited about, you know, getting work, we’ve had different nonprofit providers and for profit, you know, kind of providers and operators come to us saying, Hey, what is this about kind of social impact and trying to attract new investors? And can we do some type of bond models? So we actually had a lot of interest from a variety of different stakeholders, from lenders to operators, saying, you know, how can we move these forward? So we’re very excited and hopefully won’t take five years. And hopefully, we’ll, we will all have eaten the delicious cauliflower before that.

Michael Hughes 42:10
That’s so awesome. And guys, it’s, I’m so thankful to have had you both on the podcast today. I think we should be doing this on an annual basis. Yeah, I think we should be seeing how the needle moves on this. And, you know, and before we end the show, we do have three questions that we like to ask our guests about their own experiences with aging. And we can do round robin, or however you might like, or may just pick on one or both of you. I’m not sure. But just to reiterate, we read out the title of the study, I’m not going to do that, again, no QCon Foundation website is where you can pick it up and read it. Lots of great insights. And we hope that you will send thoughts on that back to us. And we can, we can hear all your good ideas. So question number one. For either of you, when you think about how you’ve aged? What do you think has changed about you are grown with you that you really like yourself

Caitlin MacLean 43:02
more and take it first.

Lauren Dunning 43:04
I have really appreciated the cultivation of patients. I really look back and see enormous growth in myself about being able to sit back, look through multiple lenses, understand people’s other people’s perspectives around a table, and really try to find sort of meaningful solutions that meet a lot of needs. And that can help with creativity. And so I didn’t expect that as they aged, I would feel like I was a better critical thinker, right. But I really do feel like over time, that’s improving, partly because I have the patience to sit back and watch some things unfold and try to make different connections in my head that I might have before. And I only think that’s gonna get better. And so I’m actually really excited for what I might write in 30 years or 40 years. And I’m still gonna think this report is very good that we’re talking about, but who knows, maybe 40 years from now, um, you know, a whole new ballgame. You

Michael Hughes 44:07
know, people and their people. Reverend, Reverend Bethel, tell you people over there over 65 are the most creative people out there. So I think you’ve got lots of room out there. Caitlin, either the previous question or this next one, because I know we’re running into time. And what this will pick on you, Caitlin, what has surprised you, what has surprised you the most about you, as you’ve aged? Well,

Caitlin MacLean 44:30
I would say that, unlike Warren, I am a New Yorker. So I never had patience to begin with. That was never something that was going to grow with me. You know what, I think that what surprised me the most is you know how easy it is to now set up boundaries. Because you know what you want and you know what you need in your life. And I would say you know, as you’re younger you know kind of you look at and you’re like I’m afraid to say no or I’m afraid to say yes. Or I’m, you know, I don’t want to, you know, kind of make anyone uncomfortable. And I think that, you know, kind of surprising. And I’ve always been that sort of person. And so as I’ve gotten older, like, wow, this is actually surprisingly simple to just start saying no to things. And to or to start saying, Yes, we should live in Yes, I guess. But, you know, to start saying, you know, this is what I’m, this is what I’m going to be, you know, working on, or this is what I’m going to care about, this is how I’m going to build my family, or this is where I’m going to live. Like, I think that just, I, you hear all the time people say, Oh, when I get into my 40s or 50s or 60s, I feel so much more comfortable in my skin. And I can say these types of things. And it’s one of those, you know, kind of a kind of pieces of advice that you hear and you’re like, Yeah, that’s probably not at all true. It’s actually surprisingly true. Like, wow, I really, I do, I am able to kind of create these boundaries and create that life that I’m looking for and feel okay about saying that out loud. I

Michael Hughes 45:55
I love that. And I think that’s such a terrific. Okay, so for either of you. Last question is if someone has been, is there someone that you’ve met or been in your life that has inspired you to age with abundance isn’t really a good example for you and age, I want to be like that person when I grow up.

Caitlin MacLean 46:15
So I will just say, I know Lauren has a good example. So I’m gonna say very quickly, because it’s sort of cliche that it’s my grandmother, Audrey, but I’ll tell you why not just because she was cool. But because my grandmother was an opera singer, when she was a teenager, she gave birth to 10 children. And so she clearly was not an opera singer for a very long time, because she birthed and raised 10 children. And so she kind of gave that up. And when all the kids were out of the house, she actually was like, You know what it’s not, it’s an encore career in a different way. I’m going back, and I’m going to pursue my opera career or pursue a theatrical career, you know, get my headshots get my age, and get all these things that I need to start performing again, she never really gave that up, despite the fact that generation needed to give up, you know, having a career just for staying home. And so it was always very inspirational to me, as a child to see that you know, something that you love and passion that you have never really goes away. And it doesn’t matter what age you are, you can always achieve those dreams. So that’s what I’d say.

Lauren Dunning 47:15
I love that. Me too. I have really had the benefit of happenstance, intergenerational program, which is my local community garden, right? If you’d have asked me 15 years ago, Lauren, do you want a 96 year old best friend, I don’t think I would have lined up in the 96 year old best friend community program line. But I showed up one day doing a work project on community gardens. And I had somebody say, Well, if you really would like to see how this place works, why don’t you come do some work. And so that was my invitation. And it was an invitation to an incredible relationship with an A person that really, to me is living, abundant aging, because he is really putting into action, one purpose and to Grayson aging, right? Because I have a photo of him from seven years ago, right 88, standing with a power drill on top of a raised garden bed installing an arbor. And that’s not what we’re where we’re at today. But I haven’t heard anyone say I really need to be able to do that, or I missed that or my life isn’t living if I can’t do that. He’s sorting seeds. And we’re making interesting crosses of different types of beans, we like to grow and make really perfect tomatoes, you’re in, you’re out. And so he’s finding things that include joy, as our bodies inevitably change and our capacities change. And that’s one thing as an athletic person, it’s worried me, but the fact that he can say, I’m changing, and it’s okay. And I’m helping other people find joy, because that’s the other thing is he is sharing mentorship, expertise, and his time, very generously on a daily basis with an array of people of different ages and interests at our garden. And so, I just, if you’re talking about five year goals, I really hope to see and get more growth of intergenerational programming that helps bring the generations together. That gives an opportunity for generativity, right, the giving of one generation to another and that really actually has great connection to purpose and wellbeing, and we need more opportunities for that so I’m excited for it. It’s made my life better. And

Michael Hughes 49:35
I say you know that an example you share I mean, that’s normal. Having a 96 year old doing community garden that’s normal. There are that’s normal, you know, these are normal. This isn’t it’s not you don’t need to do so they fantastic to prove that you’re aging well or skydive or whatever this is normal stuff. So I just have great gratitude to you for bringing that example to life Lauren, and gratitude to Caitlin, for the wonderful examples that you shared. Yeah. So inspiring your grandma is so inspiring. 10 Kids st. And not

Caitlin MacLean 50:10
I mean, she just lost. She ate her vegetables. I’m gonna be honest, like she ate her vegetables, you know? 10 kids. Yeah. I’m

Michael Hughes 50:19
sure that she did God bless her. And but gratitude thanks most of all to the listeners. And thanks to Eric, thank you for tuning into this episode of The Art of Aging, which is part of the abundant aging podcast series from United Church Homes. And we want to hear from you what solutions are you thinking about to address our future cost of long term care? What do you think about the connection between housing and health? Who is your abundant ag hero we want to hear from you. So visit us at abundantagingpodcast.com to give us your feedback. You can hear all of our other episodes there. You can also visit YouTube and search under United Church homes and also on Spotify if you search and find an aging podcast. Thanks again to Caitlin and Lauren from the Milken Institute. And please check out their website to download the report we’ve been talking about today, and we hope to have you join us for another episode in the future. Thanks for listening. We’ll see you next time.